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June 1992

Painful Nodules in a Young Female

Author Affiliations

New York (NY) University Medical Center

Arch Dermatol. 1992;128(6):849-850. doi:10.1001/archderm.1992.01680160133022

REPORT OF A CASE  A 15-year-old white girl presented with a 6-month history of painful nodules of the elbows and knees. The patient was otherwise in good health and was not taking any medications. Family history was notable for her father's discoid lupus erythematosus.Physical examination revealed multiple erythematous, indurated plaques and nodules of the elbows, knees, ears, and the dorsal aspects of her fingers (Fig 1). Some of the lesions had overlying scale and some had central necrosis. Laboratory findings disclosed the following results or values: complete blood cell count, electrolytes, serum urea nitrogen, creatinine, prothrombin time, partial thromboplastin time, cryoglobulins, complement studies, VDRL, and urinalysis, normal or negative; erythrocyte sedimentation rate, 49 mm/h; antinuclear antibody (ANA), positive (titer, 1:80) with a weak speckled pattern; and anticardiolipin antibodies: IgG, elevated, 15 units (normal, <3); and both IgM and IgA, less than 5 units (normal, <5). A biopsy specimen of

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